Cystoscopic placement of transurethral stent in a fetus with urethral stenosis

Ultrasound Obstet Gynecol. 2014 Aug;44(2):238-40. doi: 10.1002/uog.13293. Epub 2014 Jun 26.

Abstract

We report the case of a fetus with severe megabladder, displaying the 'keyhole' sign on ultrasound imaging, that underwent cystoscopy at 22 weeks' gestation. There was a familial history of mild urethral atresia. Fetal cystoscopy revealed congenital urethral atresia. A guide wire was advanced through the fetal urethra and a transurethral vesicoamniotic stent was placed successfully. The fetus was delivered at 36 weeks' gestation and postnatal cystoscopy confirmed the absence of posterior urethral valves or urethral atresia. The infant was 5 years old with normal renal function at the time of writing. We conclude that fetal cystoscopic placement of a transurethral stent for congenital urethral stenosis is feasible.

Keywords: cystoscopy; fetal lower urinary tract obstruction; fetal surgery; laser therapy; posterior urethral valves; urethral atresia; urethral stenosis; vesicoamniotic shunting.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Catheterization
  • Cystoscopy / methods*
  • Female
  • Fetal Diseases / diagnostic imaging
  • Fetal Diseases / surgery*
  • Fetus / surgery*
  • Gestational Age
  • Humans
  • Infant
  • Male
  • Pregnancy
  • Stents*
  • Ultrasonography, Prenatal / methods
  • Urethra / diagnostic imaging*
  • Urethra / embryology
  • Urethral Obstruction / diagnosis
  • Urethral Obstruction / diagnostic imaging
  • Urethral Obstruction / surgery
  • Urethral Stricture / diagnostic imaging
  • Urethral Stricture / surgery*
  • Urinary Bladder / abnormalities
  • Urinary Bladder / diagnostic imaging